1982 Volume 34 Issue 4 Pages 1049-1059
A 62 year old male was hospitalized on Dec.13,1979. He was complaining of back pain and his previous doctor had pointed out an abnormal shadow on his chest X-ray film.
Although cytological examinations of the patient's sputum revealed Pap. Class I V-V, a keratinized squamous cell carcinoma of the lung, his plain chest X-ray examination, tomography and computerized tomography suggested the presence of a possible extrapulmonary tumor on the right lung and adenocarcinoma in the lower lobe of the left lung. Lab. data: liver and renal functions normal
CRP 1+
CEA 33.3
PPD skin test positive
PHA skin test positive
blood gas analysis within normal limit
He was treated with Pepleomycin and Mitomycin-C regimen (PM regimen). After the 5th course of PM regimen, his genral condition deteriorated. The patient died of respiratory failure on April 15,1980 and the autopsy revealed that he had suffered from bilateral, primary double lung cancer. A epidermoid carcinoma, which originated from the S6 region of the right lung, had invaded right pleural cavity, the diaphragm, the percardium, the right IXth rib and the IXth thoracic vertebrae. On the other hand, a well differentiated adenocarcinoma was located mainly in the lower lobe of the left lung. Microscopic examination revealed no evidence, in either lung, of metastatic sites from the cancer of the opposite lung. In addition, the hilar lymphnodes were determined to be free of any metastatic sites from either lung.
Primary double lung cancer is of very rare incidence. In Japa n, in 1976 and in 1977, it was found in autopsy reports in approximately 0.6% of all lung cancer cases. The percentage of occurence drops even lower to 0.16% for primary double lung carcinomas, in which each lung has independently developed histologically different cancers.
